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Site We 1661 - 1 <br /> Affords -Te $ t Designated Operator <br /> 4162 "d Street g; p <br /> Galt, Ca 95632 Monthly Inspection Checklist <br /> 209444-0112 Fax 209=744-011. 6 <br /> Site : WINE COUNTRY 7 6 Date : 6/7/ 10/ 18 <br /> 1111 E . KETTLEMAN LANE <br /> LODI, CA 95240 <br /> ® Zane A. Nimmo ❑ David A. Winlder ❑ Felix G . Ramirez ❑ Edward Stearns <br /> #8883064 #8883059 #8883072 #8883080 <br /> )j <br /> l <br /> Y = ycs N = no, NA = nota > 1icable <br /> MONITORING PANEL / ALARM HISTORY Y N NA <br /> Monitoring system is powered on and in proper operating mode . X <br /> Monitoring system is not currently showing any alarms or warnings . X <br /> Alarm history report/log for the previous month is available, and has been reviewed by the Designated UST X <br /> Operator. (Attach a copy o the alarm histor � iyportllog to this brut if available) <br /> Each alarm for the previous month has been responded to appropriately X <br /> Sensors located in tank-top containment sumps have not alarmed in the past month. X <br /> List all tank-top sumps where alarms occurred in the past month: <br /> Note: Suutps where art alarm has occurred in the past month must be inspected urdess a qualified service technician responded to, and properly <br /> addressed, the cause of the alarm. Attach documentation verifying appropriate service to this report. tfswitp inspection is required, record results <br /> in item 6, below. <br /> UST SYSTEM INSPECTION <br /> Y I N I NA Y N NA <br /> Tank-top containment sumps are free of water, debris, and hazardous substance. Sensors are located properly. <br /> Note: Visual inspection o ,rum s is o»l y re aired in stun rs where an alarm has occurred in the gqst mondr for which there is no senlice record. <br /> Sump Location : 87 OCTANE S T P X Sump Location: X <br /> Sump Location : 91 OCTANE S T P X Sump Location : X <br /> Sump Location : DIESEL S TP X Sump Location : X <br /> Sump Location : X Sump Location : X , <br /> Sump Location: X Sump Location : X <br /> Spill containment structures are free of water, debris, & hazardous substance. <br /> Tank 1 — 87 OCTANE X Tank 5 - X <br /> Tank 2 — 91 OCTANE X Tank 6- X <br /> Tank 3 — DIESEL X Tank 7- X <br /> Tank 4 - X Tank 8- X <br /> UnderAis enser containment free of water, debris, & hazardous substance. Sensors located properly. <br /> Dispenser 1 /2 X Dispenser X <br /> Dispenser 3/4 X Dispenser X <br /> Dispenser 5/6X Dispenser X <br /> Dispenser 7/8 X Dispenser X <br /> Dispenser 9/ 10X Dispenser X <br /> Dispenser 11 / 12 X Dispenser X <br /> Dispenser 13 / 14 X Dispenser X <br /> I Dispenser 15/ 16 X Dispenser X ' <br /> i <br /> Dispenser 17/ 18 X Dispenser X <br /> E <br /> I <br /> s <br />